Healthcare Provider Details

I. General information

NPI: 1265752828
Provider Name (Legal Business Name): DANIELLE M BARNES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL MEDICAL CENTER SAN DIEGO BUILDING 2 1 DR STE 100
SAN DIEGO CA
92134-2360
US

IV. Provider business mailing address

NAVAL MEDICAL CENTER SAN DIEGO, BUILDING 2-1 34520 BOB WILSON DR, SUITE 100
SAN DIEGO CA
92134
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-6896
  • Fax: 619-532-9184
Mailing address:
  • Phone: 619-532-6896
  • Fax: 619-532-9184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA125243
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberA125243
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: